重症冠心病患者应激血糖和高敏C反应蛋白及年龄的比较

Clinical observation of stress blood glucose, high sensitivity C reactive protein and age in patients with severe coronary heart disease

目的 比较重症急性冠心病患者应激状态下血糖、高敏C反应蛋白及年龄的差异.方法 回顾性分析河北省唐山市工人医院2011年1月至2013年1月ICU和心内科住院的553例重症冠心病患者的高敏C反应蛋白、应激血糖和年龄.按照诊断将患者分为急性心力衰竭（AHF）组（104例）、ST段抬高型心肌梗死（STEMI）组（220例）、非ST段抬高型心肌梗死（NSTEMI）组（123例）、不稳定型心绞痛（UAP）组（106例）.应用非参数检验比较4组重症冠心病患者应激血糖、高敏C反应蛋白及年龄的差异.结果 NSTEM组与UAP组的应激血糖比较差异无统计学意义[（8±5）mmol/L比（8±4）mmoL/L,P＞0.05],其余两两比较差异均有统计学意义[AHF组：（14 ±7）mmol/L,STEMI组：（10±5）mmol/L,UAP组：（8±4） mmol/L,均P＜0.05];STEMI组与NSTEMI组的高敏C反应蛋白比较差异无统计学意义[（37±16） mg/L比（31±17） mg/L,P＞0.05],其余两两比较差异均有统计学意义[AHF组：（40±23） mg/L,UAP组：（27±12） mg/L,均P＜0.05];STEMI组与UAP组的年龄比较差异无统计学意义[（65±13）岁比（64±13）岁,P＞0.05],其余两两比较差异均有统计学意义[AHF组：（74±11）岁,NSTEMI组：（69±11）岁,均P＜0.05].结论 在重症急性冠心病组中AHF组的应激血糖、高敏C反应蛋白及年龄最高,且由UAP组到AHF组呈现增高趋势.

Objective To compare the differences of stress blood glucose,high sensitivity C reactive protein and age in patients with severe acute coronary heart disease.Methods The high sensitivity C reactive protein,stress blood glucose and age were observed in 553 patients with severe coronary heart disease from January 2011 to January 2013.The patients were divided into acute heart failure （AHF） group （n =104）,ST-segment elevation myocardial infarction （STEMI） group （n =220）,non-ST-segment elevation myocardial infarction （NSTEMI） group （n =123） and unstable angina pectoris （UAP） group （n =106）.The differences of high sensitivity C reactive protein,stress blood glucose and age were analyzed through Nonparametric Test.Results The differences of high sensitivity C reactive protein,stress blood glucose and age among four groups were statistically significant （P 〈 0.05）.The differences of stress blood glucose between NSTEMI group and UAP group were not statistically significant [NSTEMI group：（8 ± 5） mmol/L vs UAP：（8 ± 4） mmol/L,P 〉 0.05],whereas there were statistically significant in remaining every two groups [AHF group：（14 ± 7） mmol/L,STEMI group：（10 ± 5） mmol/L,NSTEMI group：（8 ± 5） mmol/L,UAP group：（8 ± 4） mmol/L,P 〈 0.05].The differences of high sensitivity C reactive protein between STEMI group and NSTEMI group were not statistically significant [STEMI：（16 ± 37） mg/L,NSTEMI：（17 ± 31）mg/L,P 〉0.05].The difference of age between STEMI group and UAP group was not statistically significant [STEMI group：（65 ± 13） years old,UAP group：（64 ± 13） years old,P 〉0.05].Conclusion Stress blood glucose,high sensitivity C reactive protein and age in AHF group show the highest level and there is an increasing level from UAP group to AHF group.